Focal neurological deficits secondary to intraoperative CSF drainage: successful resolution with an epidural blood patch

Report of two cases

Restricted access

✓ Two cases of focal neurological deficit secondary to intraoperative cerebrospinal fluid drainage are presented. Successful resolution was achieved by use of an epidural blood patch. Possible etiological mechanisms and prevention of the complication are discussed.

Article Information

Address reprint requests to: Russel H. Patterson, Jr., M.D., Department of Neurosurgery, The New York Hospital-Cornell Medical Center, 525 East 68th Street, New York, New York 10021.

© AANS, except where prohibited by US copyright law.

Headings

Figures

  • View in gallery

    Artist's drawings demonstrate (left) a significant CSF leak from the lumbar theca in a patient with a markedly concave decompression site, and (right) the epidural blood patches creating a normalization of pressure and return of normal CSF flow.

References

  • 1.

    Cass WEdelist G: Postspinal headache: successful use of epidural blood patch 11 weeks after onset. JAMA 227:7867871974Cass W Edelist G: Postspinal headache: successful use of epidural blood patch 11 weeks after onset. JAMA 227:786–787 1974

  • 2.

    DiGiovanni AJDunbar BS: Epidural injections of autologous blood for postlumbarpuncture headache. Anesth Analg 49:2682701970DiGiovanni AJ Dunbar BS: Epidural injections of autologous blood for postlumbarpuncture headache. Anesth Analg 49:268–270 1970

  • 3.

    DiGiovanni AJGalbert MWWahle WM: Epidural injection of autologous blood for postlumbar-puncture headache. 2. Additional clinical experiences and laboratory investigation. Anesth Analg 51:2262321972DiGiovanni AJ Galbert MW Wahle WM: Epidural injection of autologous blood for postlumbar-puncture headache. 2. Additional clinical experiences and laboratory investigation. Anesth Analg 51:226–232 1972

  • 4.

    DuPont FSSphire RD: Epidural blood patch. An unusual approach to the problem of post spinal anesthetic headache. Mich Med 71:1051071972DuPont FS Sphire RD: Epidural blood patch. An unusual approach to the problem of post spinal anesthetic headache. Mich Med 71:105–107 1972

  • 5.

    Glass PMKennedy WF Jr: Headache following subarachnoid puncture. Treatment with epidural blood patch. JAMA 219:2032041972Glass PM Kennedy WF Jr: Headache following subarachnoid puncture. Treatment with epidural blood patch. JAMA 219:203–204 1972

  • 6.

    Gormley JB: Treatment of post-spinal headache. Anesthesiology 21:5655661960Gormley JB: Treatment of post-spinal headache. Anesthesiology 21:565–566 1960

  • 7.

    Heldt TJ: Lumbar puncture headache. Med J Rec 129:1361391929Heldt TJ: Lumbar puncture headache. Med J Rec 129:136–139 1929

  • 8.

    Nelson MO: Postpuncture headaches. A clinical and experimental study of the cause and prevention. Arch Dermatol Syph 21:6151930Nelson MO: Postpuncture headaches. A clinical and experimental study of the cause and prevention. Arch Dermatol Syph 21:615 1930

  • 9.

    Ozdil TPowell WF: Post lumbar puncture headache: an effective method of prevention. Anesth Analg 44:5425451965Ozdil T Powell WF: Post lumbar puncture headache: an effective method of prevention. Anesth Analg 44:542–545 1965

  • 10.

    Thorsén G: Neurological complications after spinal anesthesia. Acta Chir Scand 95:Suppl 1211947Thorsén G: Neurological complications after spinal anesthesia. Acta Chir Scand 95: Suppl 121 1947

TrendMD

Metrics

Metrics

All Time Past Year Past 30 Days
Abstract Views 58 58 7
Full Text Views 170 170 0
PDF Downloads 80 80 0
EPUB Downloads 0 0 0

PubMed

Google Scholar